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van Bruggen S, Bennett RJ, Manchaiah V, Jager LBD, Swanepoel DW. Perceptions of Hearing Health Care: A Qualitative Analysis of Satisfied and Dissatisfied Online Reviews. Am J Audiol 2024; 33:386-410. [PMID: 38483218 DOI: 10.1044/2024_aja-23-00180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
PURPOSE The aim of this study was to examine the hearing health care experience of satisfied and dissatisfied consumers as reported on Google reviews. METHOD Using qualitative thematic analysis, open-text responses from Google regarding hearing health care clinics across 40 U.S. cities were examined. During the original search, 13,168 reviews were identified. Purposive sampling led to a total of 8,420 five-star reviews and 321 one-star reviews. The sample consisted of 500 five-star (satisfied) and 234 one-star (dissatisfied) reviews, describing experiences with audiology clinics, excluding reviews related to ear, nose, and throat services; other medical specialties; and those not relevant to hearing health care. RESULTS Satisfied and dissatisfied consumer reviews yielded nuanced dimensions of the hearing health care consumer experience, which were grouped into distinct domains, themes, and subthemes. Six and seven domains were identified from the satisfied and dissatisfied reviews, encompassing 23 and 26 themes, respectively. The overall experience domain revealed emotions ranging from contentment and gratitude to dissatisfaction and waning loyalty. The clinical outcomes domain highlights the pivotal contribution of well-being and hearing outcomes to the consumer experience, while the standard of care domain underscores shared expectations for punctuality, person-centered care, and efficient communication. Facility quality, professional competence, and inclusive care were also highlighted across positive and negative reviews. CONCLUSIONS Findings indicate dimensions of satisfied and dissatisfied hearing health care consumer experiences, identifying areas for potential service refinement. These consumer experiences inform person-centric service delivery in hearing health care.
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Affiliation(s)
- Sanchia van Bruggen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Rebecca Jane Bennett
- National Acoustic Laboratories, Macquarie University, Sydney, New South Wales, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab (a collaborative initiative between the University of Colorado and the University of Pretoria), Aurora, CO
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, India
| | - Leigh Biagio-de Jager
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab (a collaborative initiative between the University of Colorado and the University of Pretoria), Aurora, CO
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora
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Huang AR, Reed NS, Deal JA, Arnold M, Burgard S, Chisolm T, Couper D, Glynn NW, Gmelin T, Goman AM, Gravens-Mueller L, Hayden KM, Mitchell C, Pankow JS, Pike JR, Schrack JA, Sanchez V, Coresh J, Lin FR. Depression and Health-Related Quality of Life Among Older Adults With Hearing Loss in the ACHIEVE Study. J Appl Gerontol 2024; 43:550-561. [PMID: 38016096 PMCID: PMC10981564 DOI: 10.1177/07334648231212291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
Hearing loss is associated with cognitive/physical health; less is known about mental health. We investigated associations between hearing loss severity, depression, and health-related quality of life among older adults with unaided hearing loss. Data (N = 948) were from the Aging and Cognitive Health Evaluation in Elders Study. Hearing was measured by pure-tone average (PTA), Quick Speech-in-Noise (QuickSIN) test, and the Hearing Handicap Inventory for the Elderly (HHIE-S). Outcomes were validated measures of depression and health-related quality of life. Associations were assessed by negative binomial regression. More severe hearing loss was associated with worse physical health-related quality of life (ratio: .98, 95% CI: .96, 1.00). Better QuickSIN was associated with higher mental health-related quality of life (1.01 [1.00, 1.02]). Worse HHIE-S was associated with depression (1.24 [1.16, 1.33]) and worse mental (.97 [.96, .98]) and physical (.95 [ .93, .96]) health-related quality of life. Further work will test effects of hearing intervention on mental health.
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Affiliation(s)
- Alison R. Huang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michelle Arnold
- College of Science and Mathematics, University of South Florida Sarasota - Manatee, Sarasota, FL, USA
| | - Sheila Burgard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Theresa Chisolm
- College of Science and Mathematics, University of South Florida Sarasota - Manatee, Sarasota, FL, USA
| | - David Couper
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Nancy W. Glynn
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Theresa Gmelin
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Adele M. Goman
- School of Health and Social Care, Edinburgh Napier University, UK
| | - Lisa Gravens-Mueller
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kathleen M. Hayden
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christine Mitchell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - James Russell Pike
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Victoria Sanchez
- College of Science and Mathematics, University of South Florida Sarasota - Manatee, Sarasota, FL, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Frank R. Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Pan L, Li C, Meng L, Zhang G, Zou L, Tian Y, Chen S, Sun Y, Su D, Zhang X, Xiong M, Xiao T, Xia D, Hong Z, Zhang Z. GDF1 ameliorates cognitive impairment induced by hearing loss. NATURE AGING 2024; 4:568-583. [PMID: 38491289 DOI: 10.1038/s43587-024-00592-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/16/2024] [Indexed: 03/18/2024]
Abstract
Hearing loss is associated with an increased risk of Alzheimer disease (AD). However, the mechanisms of hearing loss promoting the onset of AD are poorly understood. Here we show that hearing loss aggravates cognitive impairment in both wild-type mice and mouse models of AD. Embryonic growth/differentiation factor 1 (GDF1) is downregulated in the hippocampus of deaf mice. Knockdown of GDF1 mimics the detrimental effect of hearing loss on cognition, while overexpression of GDF1 in the hippocampus attenuates the cognitive impairment induced by deafness. Strikingly, overexpression of GDF1 also attenuates cognitive impairment in APP/PS1 transgenic mice. GDF1 activates Akt, which phosphorylates asparagine endopeptidase and inhibits asparagine endopeptidase-induced synaptic degeneration and amyloid-β production. The expression of GDF1 is downregulated by the transcription factor CCAAT-enhancer binding protein-β. These findings indicate that hearing loss could promote AD pathological changes by inhibiting the GDF1 signaling pathway; thus, GDF1 may represent a therapeutic target for AD.
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Affiliation(s)
- Lina Pan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chunrui Li
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lanxia Meng
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Guoxin Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Zou
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ye Tian
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Sen Chen
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Sun
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dandan Su
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xingyu Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Min Xiong
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tingting Xiao
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Danhao Xia
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhengyuan Hong
- PET-CT/MRI Center, Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhentao Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China.
- TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan, China.
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Jansen LA, van Wier MF, Vernimmen FPJ, Goderie T, van de Berg R, Lemke U, Lissenberg-Witte BI, Kramer SE. Ten-year association between change in speech-in-noise recognition and falls due to balance problems: a longitudinal cohort study. BMC Public Health 2024; 24:732. [PMID: 38454406 PMCID: PMC10919036 DOI: 10.1186/s12889-024-18187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This study examined the relationship between speech-in-noise recognition and incident/recurrent falls due to balance problems ten years later (RQ-1); 10-year change in speech-in-noise recognition and falls (RQ-2a), as well as the role of dizziness in this relationship (RQ-2b). The association between hearing aid use and falls was also examined (RQ-3). METHODS Data was collected from the Netherlands Longitudinal Study on Hearing between 2006 and December 2022. Participants completed an online survey and digits-in-noise test every five years. For this study, data was divided into two 10-year follow-up time intervals: T0 (baseline) to T2 (10-year follow-up), and T1 (5-years) to T3 (15-years). For all RQs, participants aged ≥ 40 years at baseline, without congenital hearing loss, and non-CI users were eligible (n = 592). Additionally, for RQ-3 participants with a speech reception threshold in noise (SRTn) ≥ -5.5 dB signal-to-noise ratio were included (n = 422). Analyses used survey variables on hearing, dizziness, falls due to balance problems, chronic health conditions, and psychosocial health. Logistic regressions using General Estimating Equations were conducted to assess all RQs. RESULTS Among individuals with obesity, those with poor baseline SRTn had a higher odds of incident falls ten years later (odds ratio (OR):14.7, 95% confidence interval (CI) [2.12, 103]). A 10-year worsening of SRTn was significantly associated with a higher odds of recurrent (OR: 2.20, 95% CI [1.03, 4.71]) but not incident falls. No interaction was found between dizziness and change in SRTn. Hearing aid use (no use/ < 2 years use vs. ≥ 2 years) was not significantly associated with incident nor recurrent falls. Although there was a significant interaction with sex for this association, the effect of hearing aid use on incident/recurrent falls was not statistically significant among males nor females. CONCLUSIONS A longitudinal association between the deterioration in SRTn and recurrent falls due to balance problems after 10 years was confirmed in this study. This result stresses the importance of identifying declines in hearing earlier and justifies including hearing ability assessments within fall risk prevention programs. Mixed results of hearing aid use on fall risk warrant further investigation into the temporality of this association and possible differences between men and women.
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Affiliation(s)
- Lotte A Jansen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
| | - Marieke F van Wier
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Freek P J Vernimmen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Thadé Goderie
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands
| | - Ulrike Lemke
- Research & Development, Sonova AG, Staefa, Switzerland
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Sophia E Kramer
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Newsted D, Cooke B, Rosen E, Nguyen P, Campbell RJ, Beyea JA. Hearing aid utilization in Ontario - a population based study. Disabil Rehabil Assist Technol 2024; 19:383-389. [PMID: 35916329 DOI: 10.1080/17483107.2022.2091168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/10/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Hearing loss is one of the most common sensory impairments and hearing aids are the most common unmet assistive device need among individuals with a disability. The benefits of hearing interventions are well-documented as they are known to deter the sequalae of hearing loss including social isolation, poor mental health, falls and cognitive decline. Identifying trends in hearing aid users can provide valuable information for improving access to hearing loss interventions. METHODS Data were retrieved from ICES databases that were used to generate a cohort of 372,448 individuals in Ontario, Canada, who first claimed hearing aids between April 2007 and March 2018 through the Assistive Devices Program. RESULTS The data indicated that the frequency distribution of hearing aids has steadily inclined since 2007. The mean age of hearing aid users was 70.25 ± 14.70 years and higher neighbourhood income quintile was associated with greater hearing aid use (p < 0.001). Most first claims occurred after visiting primary care physicians (70.60%) compared with otolaryngology (13.39%). An examination of clinical comorbidities revealed hypertension (63.41%), and diabetes (24.93%) to be the most common. Regression analysis demonstrated a positive associated between age and most comorbidities. Furthermore, higher neighbourhood income quintiles were associated with a reduced risk of having the examined comorbidities. CONCLUSIONS This study examines patient demographics and clinical comorbidities in a cohort of hearing aid users in Ontario. The results identify associations between demographics and comorbidities that provide information relevant for improving access to hearing interventions and clinical decision-making in primary care.Implications for RehabilitationScreening for hearing loss (using an audiogram) in elderly individuals that manage multiple comorbidities, and any patient with significant risk factors for hearing loss (e.g., noise exposure history, prior ototoxic medications, prior head injury, history of ear surgery, family history of hearing loss) will identify deficits and direct appropriate hearing interventions.Improving access to care in low-income communities should include community-based education around expectation management and communication strategies to reinforce proper use and care of hearing devices.Geographic proximity to hearing testing facilities and hearing aid dispensaries is a significant barrier to hearing rehabilitation strategies.
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Affiliation(s)
- Daniel Newsted
- Division of Otolaryngology - Head and Neck Surgery, Kingston Health Sciences Centre, Queen's University, Kingston, Canada
| | - Bonnie Cooke
- Department of Speech Language Pathology and Audiology, Hotel Dieu Hospital, Kingston, Canada
| | - Emily Rosen
- Department of Speech Language Pathology and Audiology, Hotel Dieu Hospital, Kingston, Canada
| | | | | | - Jason A Beyea
- Division of Otolaryngology - Head and Neck Surgery, Kingston Health Sciences Centre, Queen's University, Kingston, Canada
- ICES, Queen's University, Kingston, Canada
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Sarant JZ, Busby PA, Schembri AJ, Fowler C, Harris DC. ENHANCE: a comparative prospective longitudinal study of cognitive outcomes after 3 years of hearing aid use in older adults. Front Aging Neurosci 2024; 15:1302185. [PMID: 38356856 PMCID: PMC10864469 DOI: 10.3389/fnagi.2023.1302185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/12/2023] [Indexed: 02/16/2024] Open
Abstract
Background With an aging population, the prevalence of hearing loss and dementia are increasing rapidly. Hearing loss is currently considered the largest potentially modifiable risk factor for dementia. The effect of hearing interventions on cognitive function should therefore be investigated, as if effective, these may be successfully implemented to modify cognitive outcomes for older adults with hearing loss. Methods This prospective longitudinal observational cohort study compared outcomes of a convenience sample of prospectively recruited first-time hearing aid users without dementia from an audiology center with those of community-living older adults participating in a large prospective longitudinal cohort study with/without hearing loss and/or hearing aids. All participants were assessed at baseline, 18 months, and 36 months using the same measures. Results Participants were 160 audiology clinic patients (48.8% female patient; mean age 73.5 years) with mild-severe hearing loss, fitted with hearing aids at baseline, and 102 participants of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging (AIBL) (55.9% female patient; mean age 74.5 years). 18- and 36-month outcomes of subsets of the first participants to reach these points and complete the cognition assessment to date are compared. Primary comparative analysis showed cognitive stability for the hearing aid group while the AIBL group declined on working memory, visual attention, and psychomotor function. There was a non-significant trend for decline in visual learning for the AIBL group versus no decline for the hearing aid group. The hearing aid group showed significant decline on only 1 subtest and at a significantly slower rate than for the AIBL participants (p < 0.05). When education effects on cognitive trajectory were controlled, the HA group still performed significantly better on visual attention and psychomotor function (lower educated participants only) compared to the AIBL group but not on working memory or visual learning. Physical activity had no effect on cognitive performance trajectory. Conclusion Hearing aid users demonstrated significantly better cognitive performance to 3 years post-fitting, suggesting that hearing intervention may delay cognitive decline/dementia onset in older adults. Further studies using appropriate measures of cognition, hearing, and device use, with longer follow-up, are required.
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Affiliation(s)
- Julia Z. Sarant
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter A. Busby
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Christopher Fowler
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - David C. Harris
- Department of Economics, The University of Melbourne, Melbourne, VIC, Australia
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Li X, Liu L, Luo N, Sun Y, Bai R, Xu X, Liu L. Association of changes in self-reported vision and hearing impairments with depressive symptoms in middle-aged and older adults: Evidence from a nationwide longitudinal study in China. Arch Gerontol Geriatr 2024; 116:105131. [PMID: 37552924 DOI: 10.1016/j.archger.2023.105131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE This study assessed the longitudinal relationship between changes in self-reported vision impairment (VI) and hearing impairment (HI), and depressive symptoms in adults aged ≥45 years. METHODS Data from the China Health and Retirement Longitudinal Study for 2015 and 2018 were used, with a sample size of 10,050. VI and HI were self-reported. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D10) was used to assess depressive symptoms. Total scores and clinically significant depressive symptoms (CES-D10 scores ≥ 10) were used as outcomes and analyzed using generalized estimating equations with identity link and logit link functions. RESULTS Of all changes in HI with good vision, only persistent HI was associated with higher CES-D10 scores (OR 95% CI: 1.09-3.30). Both new-onset and persistent VI with good hearing were associated with CES-D10 scores (OR 95% CI, new-onset: 1.70-3.52; persistent: 1.58-2.78) and clinically significant depressive symptoms (OR 95% CI, new-onset: 1.41-2.56; persistent: 1.36-2.27). Persistent dual sensory impairment (DSI) was associated with the highest CES-D10 scores (OR 95% CI: 3.63-5.97) and the highest risk of clinically significant depressive symptoms (OR 95% CI: 1.78-2.85). Those who self-reported improvements in vision and hearing still had higher CES-D10 scores (OR 95% CI: 1.35-2.83) and a higher risk of clinically significant depressive symptoms (OR 95% CI: 1.03-2.02) than those maintaining good vision and hearing. CONCLUSION Self-reported VI and DSI are closely associated with depressive symptoms. Because VI and DSI are modifiable, interventions for them could also prevent depressive symptoms.
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Affiliation(s)
- Xueying Li
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Libing Liu
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Nansheng Luo
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Yu Sun
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Ru Bai
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Xin Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110122, China.
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China.
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Mamo SK, Pearlman J, Wheeler KA. Associations Between Age-Related Hearing Loss, Cognitive Impairment, and Multiple Chronic Conditions in a Group Care Setting. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:5087-5108. [PMID: 37934882 PMCID: PMC11001376 DOI: 10.1044/2023_jslhr-23-00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/22/2023] [Accepted: 08/24/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE The purpose of this study was to explore the relationships between hearing loss, cognitive status, and a range of health outcomes over a period of 2 years in a sample of older adults who are enrolled in Program of All-Inclusive Care for the Elderly, which is a Medicare/Medicaid beneficiary program for individuals who are nursing home eligible but living in the community at time of enrollment. METHOD The sample (N = 144) includes a diverse (47% White/non-Hispanic, 35% Black/African American, and 16% Latin/Hispanic) group of adults ranging from 55 to 93 years old. We used medical chart data to measure respondents' cognitive and health status, including chronic conditions and hospital use. Hearing status was measured once at the beginning of the 2-year review period. We used logistic regression and negative binomial hurdle models for analyses. We used latent class analysis (LCA) to explore the extent to which respondents cluster into a set of "health profiles" characterized by their hearing, cognitive status, and health conditions. RESULTS We found that hearing loss is weakly associated with heart disease and diabetes and associated with cerebrovascular disease and falls; cognitive impairment is also associated with cerebrovascular disease and the number of falls. LCA indicates that respondents cluster into a variety of health profiles with a consistent pairing of hearing loss and depression. CONCLUSIONS The results are largely consistent with associations reported in epidemiological studies that include age-related hearing loss. Of particular interest in this study is the LCA that suggested that all of the profiles associated with a high likelihood of hearing loss included a high risk of depression. The co-occurrence of these two factors highlights the need to identify and treat hearing loss in older adults, especially as part of the treatment plan for individuals with depressive symptoms.
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Affiliation(s)
- Sara K. Mamo
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
| | - Jessica Pearlman
- Institute for Social Science Research, University of Massachusetts Amherst
| | - Kara A. Wheeler
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
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Venkitakrishnan S, Urbanski D, Wu YH. Efficacy and Effectiveness of Evidence-Based Non-Self-Fitting Presets Compared to Prescription Hearing Aid Fittings and a Personal Sound Amplification Product. Am J Audiol 2023; 33:1-24. [PMID: 37956699 PMCID: PMC11001427 DOI: 10.1044/2023_aja-23-00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 11/15/2023] Open
Abstract
PURPOSE In this study, we compare the efficacy and effectiveness of gain-frequency responses of evidence-based presets developed by our lab for over-the-counter hearing aids to conventional National Acoustic Laboratories' nonlinear fitting procedure, version 2 (NAL-NL2) gain-frequency response and to gain-frequency response of a personal sound amplification product (PSAP). We hypothesized that the hearing aids with our presets would perform better than a PSAP with poor frequency response and comparably to the hearing aid with NAL-NL2 frequency response. METHOD We used a single-blinded, randomized cross-over design to compare audibility, speech recognition, sound quality, listening effort, and subjective preferences in 37 participants in laboratory settings and following field trials. RESULTS The presets developed in our lab showed comparable outcomes to the hearing aids with NAL-NL2 gain-frequency response in most measured domains. Performance with the presets was better than the PSAP gain-frequency response in the domains of listening effort and sound quality in laboratory testing and speech recognition in our real-world measures. We also found that most participants (54.05%) preferred our presets over the PSAPs and were willing to pay significantly more to purchase the hearing aids with our presets. CONCLUSION Our evidence-based presets have better outcomes than a PSAP with a single, poorly suited frequency response while performing comparably to the clinical best-practice National Acoustic Laboratories condition.
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Affiliation(s)
- Soumya Venkitakrishnan
- Department of Communication Sciences and Disorders, California State University, Sacramento
| | - Dana Urbanski
- Department of Communication Sciences and Disorders, University of Minnesota Duluth
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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Campos L, Prochazka A, Anderson M, Kaizer A, Foster C, Hullar T. Consistent hearing aid use is associated with lower fall prevalence and risk in older adults with hearing loss. J Am Geriatr Soc 2023; 71:3163-3171. [PMID: 37314100 PMCID: PMC10592632 DOI: 10.1111/jgs.18461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 04/21/2023] [Accepted: 05/16/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Falls and their sequelae cost more than $50 billion every year. Older adults with hearing loss are at 2.4 times greater risk of falls than their normal hearing peers. Current research is inconclusive about whether hearing aids can offset this increased fall risk, and no previous studies considered if outcomes differed based on the consistency of hearing aid use. METHODS Individuals 60 years and older with bilateral hearing loss completed a survey consisting of the Fall Risk Questionnaire (FRQ) and questions about hearing loss history, hearing aid use, and other common fall risk factors. In this cross-sectional study, fall prevalence, as well as fall risk (based on FRQ score), was compared between hearing aid users and non-users. A separate group of consistent hearing-aid users (at least 4 h daily use for more than 1 year) was also compared with inconsistent/non-users. RESULTS Responses from 299 surveys were analyzed. Bivariate analysis found 50% reduced odds of experiencing a fall for hearing aid users compared with non-users (OR = 0.50 [95% CI: 0.29-0.85], p = 0.01). After adjusting for age, sex, hearing loss severity, and medication usage, those who reported any hearing aid use still had lower odds of falls (OR = 0.48 [95% CI: 0.26-0.90], p = 0.02) and lower odds of being at risk for falls (OR = 0.36 [95% CI: 0.19-0.66] p < 0.001) than non-users. Results for consistent hearing aid users demonstrate an even stronger association of lowered odds of falling (OR = 0.35 [95% CI: 0.19-0.67], p < 0.001) and lower odds of being at risk for falls (OR = 0.32 [95% CI: 0.12-0.59], p < 0.001), suggesting a potential dose-response relationship. CONCLUSIONS These findings suggest that use of hearing aids-especially consistent hearing aid use-is associated with lower odds of experiencing a fall or being classified as at risk for falls in older individuals with hearing loss.
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Affiliation(s)
- Laura Campos
- School of Medicine, University of Colorado-Anschutz Medical Campus
- Clinical Sciences, University of Colorado-Anschutz Medical Campus
| | - Allan Prochazka
- School of Medicine, University of Colorado-Anschutz Medical Campus
- Clinical Sciences, University of Colorado-Anschutz Medical Campus
| | - Melinda Anderson
- School of Medicine, University of Colorado-Anschutz Medical Campus
| | | | - Carol Foster
- School of Medicine, University of Colorado-Anschutz Medical Campus
| | - Timothy Hullar
- Clinical Sciences, University of Colorado-Anschutz Medical Campus
- Otolaryngology, VA Portland Health Care System
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11
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Lavie L, Tobia N, Slav-Zarfati N, Castel S, Banai K. Are Current Data Sufficient to Infer that Hearing Aids Contribute to Postural Control and Balance in Older Adults? A Systematic Review. Folia Phoniatr Logop 2023; 76:232-244. [PMID: 37717567 DOI: 10.1159/000534164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/14/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Balance and postural control are related to hearing and hearing loss, but whether they can be improved with hearing aid use in older adults is not clear. We systematically reviewed controlled studies in which balance and hearing were tested in experienced older hearing aid users to determine the potential effects of hearing aid use on balance. METHODS The review was pre-registered in PROSPERO and performed in accordance with PRISMA. The question, inclusion, and exclusion criteria were defined using the Population, Intervention, Control, Outcomes and Study design (PICOS) framework. Older adults with hearing loss and no experience with hearing aids, or balance tests conducted without hearing aids in hearing aid users served as controls. RESULTS A total of 803 studies were screened, eight of which met the inclusion and exclusion criteria and were included in the final review. Five of the eight studies found a significant correlation between the use of hearing aids and the outcomes of the balance tests. The quality of the studies was limited or moderate. Key Discussion: The role of hearing aids in balance and postural control is unclear because of the quality of the papers and the sparse reporting of hearing status and hearing aids quality of fitting and use.
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Affiliation(s)
- Limor Lavie
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Nawras Tobia
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Neta Slav-Zarfati
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Shefi Castel
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Karen Banai
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
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12
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Norin J. Hearing Loss: Insights for Home Care Clinicians. Home Healthc Now 2023; 41:248-255. [PMID: 37682737 DOI: 10.1097/nhh.0000000000001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Hearing loss is a common problem caused by aging, noise exposure, ototoxic medications, and illness. Given their frequent contact with older adults, home care clinicians are uniquely positioned to recognize the adverse effects of hearing loss on physical, social, and cognitive health. This article explores the factors that contribute to hearing loss, highlighting their cumulative effects on overall hearing ability. The consequences of untreated hearing loss support the urgency of early identification, prompt intervention, and proper management of hearing disability. This article also provides an overview of available treatment options, including traditional prescription hearing aids and recently approved over-the-counter devices. By incorporating components of awareness, treatment, and effective communication strategies, healthcare clinicians can take an integrated approach to improve the overall well-being and quality of life of individuals struggling with hearing loss.
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Affiliation(s)
- Julie Norin
- Julie Norin, AuD, CCC-A, is Clinical Assistant Professor, Department of Speech-Language Pathology and Audiology, Towson University, Towson, Maryland
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13
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Kim MW, Jin MH, Choi JY, Kwak MY. Potential overestimation of cognitive impairment because of hearing loss: impact of test modalities on cognitive test scores. J Laryngol Otol 2023; 137:845-850. [PMID: 36751924 DOI: 10.1017/s0022215123000154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Hearing impairment in older adults may affect cognitive function and increase the risk of dementia. Most cognitive tests are delivered auditorily, and individuals with hearing loss may fail to hear verbal instructions. Greater listening difficulty and fatigue in acoustic conditions may impact test performance. This study aimed to examine the effect of decreased audibility on cognitive screening test performance in older adults. METHOD Older adults (n = 63) with different levels of hearing loss completed a standard auditory Mini-Mental State Examination test and a written version of the test. RESULTS Individuals with moderate to moderately severe hearing loss (41-70 dB) performed significantly better on the written (24.34 ± 4.90) than on the standard test (22.55 ± 6.25), whereas scores were not impacted for mild hearing loss (less than 40 dB). CONCLUSION Hearing evaluations should be included in cognitive assessment, and test performance should be carefully interpreted in individuals with hearing loss to avoid overestimating cognitive decline.
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Affiliation(s)
- M W Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Daejeon Eulji Medical Centre, Eulji University, Daejeon, Republic of Korea
| | - M H Jin
- Department of Otorhinolaryngology - Head and Neck Surgery, Daejeon Eulji Medical Centre, Eulji University, Daejeon, Republic of Korea
| | - J Y Choi
- Department of Otorhinolaryngology - Head and Neck Surgery, Daejeon Eulji Medical Centre, Eulji University, Daejeon, Republic of Korea
| | - M Y Kwak
- Department of Otorhinolaryngology - Head and Neck Surgery, Daejeon Eulji Medical Centre, Eulji University, Daejeon, Republic of Korea
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14
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Higgins NC, Pupo DA, Ozmeral EJ, Eddins DA. Head movement and its relation to hearing. Front Psychol 2023; 14:1183303. [PMID: 37448716 PMCID: PMC10338176 DOI: 10.3389/fpsyg.2023.1183303] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/07/2023] [Indexed: 07/15/2023] Open
Abstract
Head position at any point in time plays a fundamental role in shaping the auditory information that reaches a listener, information that continuously changes as the head moves and reorients to different listening situations. The connection between hearing science and the kinesthetics of head movement has gained interest due to technological advances that have increased the feasibility of providing behavioral and biological feedback to assistive listening devices that can interpret movement patterns that reflect listening intent. Increasing evidence also shows that the negative impact of hearing deficits on mobility, gait, and balance may be mitigated by prosthetic hearing device intervention. Better understanding of the relationships between head movement, full body kinetics, and hearing health, should lead to improved signal processing strategies across a range of assistive and augmented hearing devices. The purpose of this review is to introduce the wider hearing community to the kinesiology of head movement and to place it in the context of hearing and communication with the goal of expanding the field of ecologically-specific listener behavior.
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Affiliation(s)
- Nathan C. Higgins
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL, United States
| | - Daniel A. Pupo
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL, United States
- School of Aging Studies, University of South Florida, Tampa, FL, United States
| | - Erol J. Ozmeral
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL, United States
| | - David A. Eddins
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL, United States
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15
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Siggaard LD, Jacobsen H, Hougaard DD, Høgsbro M. Digital vs. physical ear-nose-and-throat specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid treatment: a randomized controlled trial. Front Digit Health 2023; 5:1182421. [PMID: 37363275 PMCID: PMC10285396 DOI: 10.3389/fdgth.2023.1182421] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction This study introduces a digital assessment tool for asynchronous and remote ear-nose-and-throat (ENT) specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid (HA) treatment. The +60 population will nearly double from 12% to 22% between 2015 and 2050 increasing the incidence of age-induced hearing impairment and the need for hearing rehabilitation. If un-diagnosed, age-related hearing loss negatively affects quality of life by accelerating social distancing and early retirement as well as increasing risk of anxiety, depression, and dementia. Therefore, innovative measures are essential to provide timely diagnostics and treatment. Methods A total of 751 hearing-impaired adults without previous HA usage or experience were randomly assigned to digital or physical ENT specialist assessment screening prior to HA treatment initiation in 20 public and private hearing rehabilitation and ENT specialist clinics in the North Denmark Region. A total of 501 test group participants were assigned to digital assessment screening and 250 control group participants to physical assessment screening prior to HA treatment. Results In all, 658 (88%) participants completed the trial and were eligible for analysis. Digital screening sensitivity (0.85, 95% confidence interval (CI) 0.71-0.94) was significantly higher than physical screening sensitivity (0.2, 95% CI: 0.03-0.56). Screening specificity was high for both assessment methods. Discussion In a setting where hearing-impaired adults were assessed for HA treatment, digital ENT specialist assessment screening did not compromise patient safety or increase the risk of misdiagnosis in patients with complicated hearing loss and/or serious ear disorders when compared to physical ENT specialist assessment screening. Clinical Trial registration https://clinicaltrials.gov/ct2/show/NCT05154539, identifier: NCT05154539.
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Affiliation(s)
- Lene Dahl Siggaard
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Henrik Jacobsen
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
| | - Dan Dupont Hougaard
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Morten Høgsbro
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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16
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Baranger M, Manera V, Sérignac C, Derreumaux A, Cancian E, Vandersteen C, Gros A, Guevara N. Evaluation of the Cognitive Function of Adults with Severe Hearing Loss Pre- and Post-Cochlear Implantation Using Verbal Fluency Testing. J Clin Med 2023; 12:jcm12113792. [PMID: 37297988 DOI: 10.3390/jcm12113792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Hearing loss is a major public health problem with significant evidence correlating it with cognitive performance. Verbal fluency tests are commonly used to assess lexical access. They provide a great deal of information about a subject's cognitive function. The aim of our study was to evaluate phonemic and semantic lexical access abilities in adults with bilateral severe to profound hearing loss and then to re-evaluate a cohort after cochlear implantation. 103 adult subjects underwent phonemic and semantic fluency tests during a cochlear implant candidacy evaluation. Of the total 103 subjects, 43 subjects underwent the same tests at 3 months post-implantation. Our results showed superior performance in phonemic fluency compared to semantic fluency in subjects prior to implantation. Phonemic fluency was positively correlated with semantic fluency. Similarly, individuals with congenital deafness had better semantic lexical access than individuals with acquired deafness. Results at 3 months post-implantation showed an improvement in phonemic fluency. No correlation was found between the evolution of pre- and post-implant fluency and the auditory gain of the cochlear implant, and we found no significant difference between congenital and acquired deafness. Our study shows an improvement in global cognitive function after cochlear implantation without differentiation of the phonemic-semantic pathway.
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Affiliation(s)
- Manon Baranger
- Département d'Orthophonie de Nice (DON), UFR Médecine, Université Côte d'Azur, 06107 Nice, France
- Laboratoire CobTeK, Université Côte d'Azur, 06100 Nice, France
| | - Valeria Manera
- Département d'Orthophonie de Nice (DON), UFR Médecine, Université Côte d'Azur, 06107 Nice, France
- Laboratoire CobTeK, Université Côte d'Azur, 06100 Nice, France
| | - Chloé Sérignac
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31 Avenue de Valombrose, 06100 Nice, France
| | - Alexandre Derreumaux
- Laboratoire CobTeK, Université Côte d'Azur, 06100 Nice, France
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice (University Hospital of Nice), Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche (Geriatric Brain and Movement Clinic, Memory Resources and Research Centre), 06100 Nice, France
| | - Elisa Cancian
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31 Avenue de Valombrose, 06100 Nice, France
| | - Clair Vandersteen
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31 Avenue de Valombrose, 06100 Nice, France
| | - Auriane Gros
- Département d'Orthophonie de Nice (DON), UFR Médecine, Université Côte d'Azur, 06107 Nice, France
- Laboratoire CobTeK, Université Côte d'Azur, 06100 Nice, France
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice (University Hospital of Nice), Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche (Geriatric Brain and Movement Clinic, Memory Resources and Research Centre), 06100 Nice, France
| | - Nicolas Guevara
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31 Avenue de Valombrose, 06100 Nice, France
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17
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Dawes P, Völter C. Do hearing loss interventions prevent dementia? Z Gerontol Geriatr 2023:10.1007/s00391-023-02178-z. [PMID: 37140632 DOI: 10.1007/s00391-023-02178-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/03/2023] [Indexed: 05/05/2023]
Abstract
Hearing loss has been identified as a potentially modifiable risk for dementia. This discussion paper reviews studies examining the impact of hearing loss interventions on cognitive decline and incident cognitive impairment, identified the challenges for research on the cognitive impacts of hearing interventions, and the likely benefits of hearing interventions for healthy aging and mental well-being.
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Affiliation(s)
- Piers Dawes
- University of Queensland Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, The University of Queensland, 4072, Brisbane, QLD, Australia.
- Manchester Centre for Audiology and Deafness (ManCAD), The University of Manchester, Manchester, UK.
| | - Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Comprehensive Hearing Centre at Katholisches Klinikum, Ruhr-University, Bochum, Germany
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18
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Jiang F, Mishra SR, Shrestha N, Ozaki A, Virani SS, Bright T, Kuper H, Zhou C, Zhu D. Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort. Lancet Public Health 2023; 8:e329-e338. [PMID: 37062296 DOI: 10.1016/s2468-2667(23)00048-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Dementia and hearing loss are both highly prevalent conditions among older adults. We aimed to examine the association between hearing aid use and risk of all-cause and cause-specific dementia among middle-aged and older-aged adults, and to explore the roles of mediators and moderators in their association. METHODS We used data from the UK Biobank, a population-based cohort study, which recruited adults aged 40-69 years between 2006 and 2010 across 22 centres in England, Scotland, and Wales. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs between self-reported hearing aid use status (hearing loss with or without hearing aids) at baseline and risk of dementia (all-cause dementia, Alzheimer's disease, vascular dementia, and non-Alzheimer's disease non-vascular dementia). Dementia diagnoses were ascertained using hospital records and death-register data. We also analysed the roles of mediators (self-reported social isolation, loneliness, and mood) and moderators (self-reported education and income, smoking, morbidity, and measured APOE allele status). FINDINGS After the exclusion of people who did not answer the question on hearing difficulties (n=25 081 [5·0%]) and those with dementia at baseline visit (n=283 [0·1%]), we included 437 704 people in the analyses. Compared with participants without hearing loss, people with hearing loss without hearing aids had an increased risk of all-cause dementia (HR 1·42 [95% CI 1·29-1·56]); we found no increased risk in people with hearing loss with hearing aids (1·04 [0·98-1·10]). The positive association of hearing aid use was observed in all-cause dementia and cause-specific dementia subtypes (Alzheimer's disease, vascular dementia, and non-Alzheimer's disease non-vascular dementia). The attributable risk proportion of dementia for hearing loss was estimated to be 29·6%. Of the total association between hearing aid use and all-cause dementia, 1·5% was mediated by reducing social isolation, 2·3% by reducing loneliness, and 7·1% by reducing depressed mood. INTERPRETATION In people with hearing loss, hearing aid use is associated with a risk of dementia of a similar level to that of people without hearing loss. With the postulation that up to 8% of dementia cases could be prevented with proper hearing loss management, our findings highlight the urgent need to take measures to address hearing loss to improve cognitive decline. FUNDING National Natural Science Foundation of China and Shandong Province, Taishan Scholars Project, China Medical Board, and China Postdoctoral Science Foundation.
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Affiliation(s)
- Fan Jiang
- Centre for Health Management and Policy Research, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shiva Raj Mishra
- NHMRC Clinical Trials Center, University of Sydney, NSW, Australia; Westmead Applied Research Centre (WARC), Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Nipun Shrestha
- Evidence Integration, University of Sydney, NSW, Australia
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan; Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan
| | - Salim S Virani
- Michael E DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA; The Aga Khan University, Karachi, Pakistan
| | - Tess Bright
- Indigenous Health Equity Unit, Centre for Health Equity, University of Melbourne, Melbourne, VIC, Australia
| | - Hannah Kuper
- International Center for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, Shandong University, Jinan, China; School of Public Health, Cheeloo College of Medicine, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Dongshan Zhu
- Department of Epidemiology, Shandong University, Jinan, China.
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19
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Tamblay N, Boggs D, Huidobro B, Tapia-Mora D, Anabalon K, Delgado C, Polack S, Bright T, Torrente MC. Prevalence of Cognitive Impairment and Its Association With Hearing Loss Among Adults Over 50 Years of Age: Results From a Population-Based Survey in Santiago, Chile. Am J Audiol 2023; 32:150-159. [PMID: 36692926 DOI: 10.1044/2022_aja-22-00042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE The purpose of this study was to estimate the prevalence of cognitive impairment and explore its association with hearing loss and other sociodemographic and clinical risk factors, using an objective measurement of hearing levels, in adults over 50 years of age. METHOD A population-based survey was completed in Santiago, Chile between December 2019 and March 2020. Participants were screened for cognitive impairment using the Short Chilean Mini-Mental State Examination and hearing levels were assessed with tonal audiometry (hearTest). Data on demographic, socioeconomic, and clinical characteristics were collected. RESULTS A total of 538 persons completed the assessment. The prevalence of cognitive impairment in the 50+ population was 9.3% (95% confidence interval [CI] [5.8, 14.7]). Cognitive impairment was significantly higher in individuals with any level of hearing loss (odds ratio [OR] = 2.19, 95% CI [1.00, 4.80], adjusted for age, sex, education, socioeconomic position [SEP], and head trauma). Subjects with hearing loss and who reported any use of hearing aids (16% of the sample) had a lower risk of cognitive impairment (OR of nonusers 3.64, 95% CI [1.00, 13.28], adjusted for age, sex, education, SEP, and head trauma). CONCLUSION Strategies for addressing cognitive impairment should further explore the integration of early diagnosis of hearing loss and the regular use of hearing aids.
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Affiliation(s)
- Natalia Tamblay
- Department of Otorhinolaryngology, Faculty of Medicine, Universidad de Chile, Santiago
| | - Dorothy Boggs
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Barbara Huidobro
- Department of Otorhinolaryngology, Pontificia Universidad Católica de Chile, Santiago
| | - Daniel Tapia-Mora
- Department of Speech and Hearing Sciences, Faculty of Medicine, Universidad de Chile, Santiago.,School of Speech and Hearing Sciences, Universidad de los Andes, Santiago, Chile
| | - Katherine Anabalon
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago
| | - Carolina Delgado
- Unidad de Cerebro Saludable, Departamento de Neurología y Neurocirugía, Hospital Cínico Universidad de Chile.,Departamento de Neurociencia Facultad de Medicina Universidad de Chile, Santiago
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Tess Bright
- Centre for Health Equity, The University of Melbourne, Victoria, Australia
| | - Mariela C Torrente
- Department of Otorhinolaryngology, Faculty of Medicine, Universidad de Chile, Santiago.,Hospital Clínico Universidad de Chile, Santiago
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20
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West JS, Smith SL, Dupre ME. The impact of hearing loss on trajectories of depressive symptoms in married couples. Soc Sci Med 2023; 321:115780. [PMID: 36801754 PMCID: PMC10478395 DOI: 10.1016/j.socscimed.2023.115780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/29/2022] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Hearing loss is a prevalent chronic stressor among older adults and is associated with numerous adverse health outcomes. The life course principle of linked lives highlights that an individual's stressors can impact the health and well-being of others; however, there are limited large-scale studies examining hearing loss within marital dyads. Using 11 waves (1998-2018) of the Health and Retirement Study (n = 4881 couples), we estimate age-based mixed models to examine how 1) one's own hearing, 2) one's spouse's hearing, or 3) both spouses' hearing influence changes in depressive symptoms. For men, their wives' hearing loss, their own hearing loss, and both spouses having hearing loss are associated with increased depressive symptoms. For women, their own hearing loss and both spouses having hearing loss are associated with increased depressive symptoms, but their husbands' hearing loss is not. The connections between hearing loss and depressive symptoms within couples are a dynamic process that unfolds differently by gender over time.
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Affiliation(s)
- Jessica S West
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA.
| | - Sherri L Smith
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA; Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, NC, USA
| | - Matthew E Dupre
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA; Department of Sociology, Duke University, Durham, NC, USA
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21
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Atef RZ, Michalowsky B, Raedke A, Platen M, Mohr W, Mühlichen F, Thyrian JR, Hoffmann W. Impact of Hearing Aids on Progression of Cognitive Decline, Depression, and Quality of Life Among People with Cognitive Impairment and Dementia. J Alzheimers Dis 2023; 92:629-638. [PMID: 36776058 DOI: 10.3233/jad-220938] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Hearing loss is common in people with dementia (PwD) and a modifiable risk factor for cognitive decline. Recent studies revealed that hearing loss could cause social isolation and depression, which is associated with health-related quality of life (HRQoL). However, there is a lack of knowledge about the impact of the utilization of hearing aids on these outcomes. OBJECTIVE To assess whether hearing aids use might be positively associated with the progression of cognitive function, depression, and HRQoL among PwD. METHODS We analyzed two-year follow-up data from 258 PwD (≥70 years, living at home). Cognitive decline was measured with Mini-Mental Status Examination (MMSE), depression using Geriatric Depression Scale (GDS), and HRQoL with Quality of Life in Alzheimer's Disease Scale (QoL-AD). The impact of hearing aid utilization on the progression of outcomes was assessed using multivariate regression models. RESULTS 123 patients had hearing loss (47.7%), from which n = 54 (43.9%) used hearing aids. Patients with hearing loss were older and had a lower HRQoL than those without hearing loss. Use of hearing aids in patients with hearing loss was associated with a lower increase in symptoms (b = -0.74, CI95 -1.46 --0.01, p = 0.047) over time as compared to those not using hearing aids. There was no effect on PwD's cognition, and the association with higher HRQoL was significant after one, but not consistently over two years. CONCLUSION Early detection and intervention of presbycusis using hearing aids might improve mental health and HRQoL in dementia.
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Affiliation(s)
- Roaa Zayed Atef
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Anika Raedke
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Moritz Platen
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Wiebke Mohr
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Franka Mühlichen
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
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22
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Thwarting Alzheimer's Disease through Healthy Lifestyle Habits: Hope for the Future. Neurol Int 2023; 15:162-187. [PMID: 36810468 PMCID: PMC9944470 DOI: 10.3390/neurolint15010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/17/2022] [Accepted: 12/26/2022] [Indexed: 01/31/2023] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder that slowly disintegrates memory and thinking skills. Age is known to be the major risk factor in AD, but there are several nonmodifiable and modifiable causes. The nonmodifiable risk factors such as family history, high cholesterol, head injuries, gender, pollution, and genetic aberrations are reported to expediate disease progression. The modifiable risk factors of AD that may help prevent or delay the onset of AD in liable people, which this review focuses on, includes lifestyle, diet, substance use, lack of physical and mental activity, social life, sleep, among other causes. We also discuss how mitigating underlying conditions such as hearing loss and cardiovascular complications could be beneficial in preventing cognitive decline. As the current medications can only treat the manifestations of AD and not the underlying process, healthy lifestyle choices associated with modifiable factors is the best alternative strategy to combat the disease.
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23
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Kiely KM, Khalatbari-Soltani S, Blyth FM, Naganathan V, Handelsman DJ, Waite LM, Le Couteur DG, Mortby ME, Cumming RG, Anstey KJ. Mixed Evidence of an Association between Self-Rated Hearing Difficulties and Falls: Prospective Analysis of Two Longitudinal Studies. Gerontology 2023; 69:98-108. [PMID: 35598592 DOI: 10.1159/000524311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/21/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION This study aimed to assess the extent to which a single item of self-reported hearing difficulties is associated with future risk of falling among community-dwelling older adults. METHODS We used data from two Australian population-based cohorts: three waves from the PATH Through Life study (PATH; n = 2,048, 51% men, age 66.5 ± 1.5 SD years) and three waves from the Concord Health and Ageing in Men Project (CHAMP; n = 1,448, 100% men with mean age 77.3 ± 5.3 SD years). Hearing difficulties were recorded on a four-point ordinal scale in PATH and on a dichotomous scale in CHAMP. The number of falls in the past 12 months was reported at each wave in both studies. In CHAMP, incident falls were also ascertained by triannual telephone call cycles for up to four years. Multivariable-adjusted random intercept negative binomial regression models were used to estimate the association between self-reported hearing difficulties and number of falls reported at the following wave or 4-monthly follow-ups. RESULTS In PATH, self-reported hearing difficulties were associated with a higher rate of falls at follow-up (incidence rate ratio = 1.15, 95% CI = 1.03-1.27 per a one-level increase in self-reported hearing difficulties), after adjusting for sociodemographic characteristics, health behaviours, physical functioning, balance, mental health, medical conditions, and medications. There were no significant associations between hearing difficulties and the rate of falls based on either repeated survey or 4-monthly follow-ups in CHAMP. CONCLUSION Though we find mixed results, findings from PATH data indicate an ordinal measure of self-reported hearing loss may be predictive of falls incidence in young-old adults. However, the null findings in the male-only CHAMP preclude firm conclusions of a link between hearing loss and falls risk.
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Affiliation(s)
- Kim M Kiely
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.,The School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia
| | - Saman Khalatbari-Soltani
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Vasikaran Naganathan
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia.,Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Moyra E Mortby
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.,The School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia
| | - Robert G Cumming
- ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.,The School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), Sydney, New South Wales, Australia
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24
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Stott J, Saunders R, Desai R, Bell G, Fearn C, Buckman JEJ, Brown B, Nurock S, Michael S, Ware P, Marchant NL, Aguirre E, Rio M, Cooper C, Pilling S, Richards M, John A. Associations between psychological intervention for anxiety disorders and risk of dementia: a prospective cohort study using national health-care records data in England. THE LANCET. HEALTHY LONGEVITY 2023; 4:e12-e22. [PMID: 36509102 PMCID: PMC10570142 DOI: 10.1016/s2666-7568(22)00242-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Meta-analyses support an association between anxiety in older adulthood and dementia. The aim of this study was to use routinely collected health data to test whether treatment of anxiety disorders through psychological intervention is associated with a lower incidence of dementia. METHODS In this prospective cohort study, data from nationally provided psychological therapy services in England termed Improving Access to Psychological Therapies from 2012 to 2019 were linked to medical records, including dementia diagnoses as defined by the tenth edition of the International Classification of Diseases, up to 8 follow-up years later. Inclusion criteria were as follows: (1) patients who were aged 65 years and older; (2) patients with a probable anxiety disorder; and (3) those with no previous or current diagnosis of dementia. Cox proportional hazards models were constructed to test whether reliable improvement in anxiety following psychological intervention was associated with future dementia incidence. The primary outcome was all-cause dementia and cases were identified using ICD-10 dementia codes from Hospital Episode Statistics, Mental Health Services Dataset, and mortality data. For main analyses, hazards ratios (HRs) are presented. FINDINGS Data from 128 077 people aged 65 years and older attending a nationally provided psychological intervention service in England were linked to medical records. 88 019 (69·0%) of 127 064 participants with available gender data were women and 39 585 (31·0%) were men. 111 225 (95·9%) of 115 989 with available ethnicity data were of White ethnicity. The mean age of the sample was 71·55 years (SD 5·69). Fully adjusted models included data from 111 958 people after 16 119 were excluded due to missing data on key variables or covariates. 4510 (4·0%) of 111 958 participants had a dementia diagnosis. The remaining 107 448 (96·0%) were censored either at date of death or when the final follow-up period available for analyses was reached. People who showed reliable improvement in anxiety had lower rates of later dementia diagnosis (3·9%) than those who did not show reliable improvement (5·1%). Reliable improvement in anxiety following psychological intervention was associated with reduced incidence of all-cause dementia (HR 0·83 [95% CI 0·78-0·88]), Alzheimer's disease (HR 0·85 [0·77-0·94]), and vascular dementia (HR 0·80 [0·71-0·90]). Effects did not differ depending on anxiety disorder diagnosis. INTERPRETATION Results showed that reliable improvement in anxiety from psychological therapy was associated with reduced incidence of future dementia. There are multiple plausible explanations for this finding and further research is needed to distinguish between these possibilities. Missing data in the sample limit reliability of findings. FUNDING Alzheimer's Society, Medical Research Council, Wellcome Trust, and UCLH National Institute for Health and Care Research Biomedical Research Centre.
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Affiliation(s)
| | - Rob Saunders
- Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | | | | | | | - Joshua E J Buckman
- Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK; iCope-Camden and Islington Psychological Therapies Services, St Pancras Hospital, London, UK
| | | | | | | | | | | | | | - Miguel Rio
- Department of Electronic and Electrical Engineering, UCL, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Queen Mary University of London, London, UK
| | - Stephen Pilling
- Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK; Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
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25
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Naylor G, Dillard L, Orrell M, Stephan BCM, Zobay O, Saunders GH. Dementia and hearing-aid use: a two-way street. Age Ageing 2022; 51:6931852. [PMID: 36571777 PMCID: PMC9792081 DOI: 10.1093/ageing/afac266] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Hearing-aid use may reduce risk of dementia, but cognitive impairment makes use more challenging. An observed association between reduced hearing-aid use and incident dementia could reflect either or both of these causal paths. The objective was to examine the effects of each path while minimising contamination between paths. METHODS Health records data from 380,794 Veterans who obtained hearing aids from the US Veterans Affairs healthcare system were analysed. Analysis 1 (n = 72,180) used multivariable logistic regression to model the likelihood of incident dementia 3.5-5 years post hearing-aid fitting for patients free of dementia and mild cognitive impairment (MCI). Analysis 2 (n = 272,748) modelled the likelihood of being a persistent hearing-aid user at 3 years 2 months after fitting, contrasting subgroups by level of cognitive function at the time of fitting. Analysis time windows were optimized relative to dataset constraints. Models were controlled for available relevant predictors. RESULTS The adjusted OR for incident dementia was 0.73 (95% CI 0.66-0.81) for persistent (versus non-persistent) hearing-aid users. The adjusted OR for hearing-aid use persistence was 0.46 (95% CI 0.43-0.48) in those with pre-existing dementia (versus those remaining free of MCI and dementia). CONCLUSION Substantial independent associations are observed in both directions, suggesting that hearing-aid use decreases risk of dementia and that better cognitive function predisposes towards persistent use. Research studying protective effects of hearing-aid use against dementia needs to account for cognitive status. Clinically, hearing devices and hearing care processes must be accessible and usable for all, regardless of their cognitive status.
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Affiliation(s)
- Graham Naylor
- Address correspondence to: Graham Naylor, Hearing Sciences–Scottish Section, New Lister Building, 10-16 Alexandra Parade, Glasgow G31 2ER, UK.
| | - Lauren Dillard
- Department of Otolaryngology- Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA,VA Rehabilitation R&D, National Center for Rehabilitative Auditory Research, Portland, OR, USA
| | - Martin Orrell
- School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Oliver Zobay
- School of Medicine, University of Nottingham, Nottingham, UK,VA Rehabilitation R&D, National Center for Rehabilitative Auditory Research, Portland, OR, USA
| | - Gabrielle H Saunders
- VA Rehabilitation R&D, National Center for Rehabilitative Auditory Research, Portland, OR, USA,Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
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26
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Fornaro G, Armeni P, Albera A, Barbara M. The Value of Hearing Aids for the Italian NHS: A Cost-utility Analysis. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e018. [PMID: 38516581 PMCID: PMC10950133 DOI: 10.1097/ono.0000000000000018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/08/2022] [Indexed: 03/23/2024]
Abstract
Objective Hearing loss (HL) prevalence in Italy is expected to increase due to population aging. Hearing aids (HAs) are the main tool for HL rehabilitation; however, cost-utility analyses of HAs are limited. Our objective was to estimate the cost-utility of HAs use. Study Design Cost-utility analysis. Setting Italian National Healthcare Service, societal perspective. Patients Interventions and Main Outcome Measures A multistate Markov model was developed to model a cohort of 55-year-old individuals starting from normal hearing and moving across HL states to compare cost-utility and net monetary benefit of HA use accompanied by post-purchase service, HA use alone, and no treatment. Parameters were estimated using secondary data. Incremental cost-utility ratio (ICUR) and incremental net monetary benefit (INMB) were computed against a €16,625/quality-adjusted life year (QALY) willingness-to-pay (WTP) threshold. Deterministic and probabilistic sensitivity analysis (DSA, PSA) was implemented to assess how uncertainty affected results. Scenario analysis was performed on different assumptions on costs, dropout and compliance rates. Results The model suggests HAs use is a cost-effective strategy compared to no treatment (in the base case: incremental costs €429-€476, incremental QALY gain 0.18 and 0.19, ICUR €2'404/QALY-€2'450/QALY, INMB €2'476-€2'682 for male and female cohort, respectively). By assuming no dropout, INMBs increase up to €10,643-€10,728. DSA highlights that utility weights contribute the most to model uncertainty, PSA shows that the treatment has 97.8%-97.3% probability of being cost-effective at the WTP threshold considered. Conclusions We proposed an original model to assess the cost-utility of HAs use; the application to the Italian setting suggests the treatment is cost-effective, reinforcing the importance of early uptake.
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Affiliation(s)
- Giulia Fornaro
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, Bocconi University, Milan, Italy
- Department of Social and Political Science, Bocconi University, Milan, Italy
| | - Patrizio Armeni
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, Bocconi University, Milan, Italy
| | - Andrea Albera
- Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Turin, Italy
| | - Michele Barbara
- Department of Otorhinolaryngology, “Mons. Dimiccoli” Hospital, Barletta, Italy
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27
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James TG, Miller MD, McKee MM, Sullivan MK, Rotoli J, Pearson TA, Mahmoudi E, Varnes JR, Cheong JW. Emergency department condition acuity, length of stay, and revisits among deaf and hard-of-hearing patients: A retrospective chart review. Acad Emerg Med 2022; 29:1290-1300. [PMID: 35904003 PMCID: PMC9671827 DOI: 10.1111/acem.14573] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/12/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Deaf and hard-of-hearing (DHH) patients are understudied in emergency medicine health services research. Theory and limited evidence suggest that DHH patients are at higher risk of emergency department (ED) utilization and poorer quality of care. This study assessed ED condition acuity, length of stay (LOS), and acute ED revisits among DHH patients. We hypothesized that DHH patients would experience poorer ED care outcomes. METHODS We conducted a retrospective chart review of a single health care system using data from a large academic medical center in the southeast United States. Data were received from the medical center's data office, and we sampled patients and encounters from between June 2011 and April 2020. We compared DHH American Sign Language (ASL) users (n = 108), DHH English speakers (n = 358), and non-DHH English speakers (n = 302). We used multilevel modeling to assess the differences among patient segments in outcomes related to ED use and care. RESULTS As hypothesized, DHH ASL users had longer ED LOS than non-DHH English speakers, on average 30 min longer. Differences in ED condition acuity, measured through Emergency Severity Index and triage pain scale, were not statistically significant. DHH English speakers represented a majority (61%) of acute ED revisit encounters. CONCLUSIONS Our study identified that DHH ASL users have longer ED LOS than non-DHH English speakers. Additional research is needed to further explain the association between DHH status and ED care outcomes (including ED LOS and acute revisit), which may be used to identify intervention targets to improve health equity.
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Affiliation(s)
- Tyler G. James
- Department of Family MedicineUniversity of MichiganAnn ArborMichiganUSA
- Department of Health Education and BehaviorUniversity of FloridaGainesvilleFloridaUSA
| | - M. David Miller
- School of Human Development and Organizational Studies in EducationUniversity of FloridaGainesvilleFloridaUSA
| | - Michael M. McKee
- Department of Family MedicineUniversity of MichiganAnn ArborMichiganUSA
| | | | - Jason Rotoli
- Department of Emergency MedicineUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Thomas A. Pearson
- Department of EpidemiologyUniversity of FloridaGainesvilleFloridaUSA
| | - Elham Mahmoudi
- Department of Family MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Julia R. Varnes
- Department of Health Services Research Management and PolicyUniversity of FloridaGainesvilleFloridaUSA
| | - Jee Won Cheong
- Department of Health Education and BehaviorUniversity of FloridaGainesvilleFloridaUSA
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28
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Brewster KK, Deal JA, Lin FR, Rutherford BR. Considering hearing loss as a modifiable risk factor for dementia. Expert Rev Neurother 2022; 22:805-813. [PMID: 36150235 PMCID: PMC9647784 DOI: 10.1080/14737175.2022.2128769] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/22/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Accumulating evidence links hearing loss to impaired cognitive performance and increased risk for dementia. Hearing loss can lead to deafferentation-induced atrophy of frontotemporal brain regions and dysregulation of cognitive control networks from increased listening effort. Hearing loss is also associated with reduced social engagement, loneliness, and depression, which are independently associated with poor cognitive function. AREAS COVERED We summarize the evidence and postulated mechanisms linking hearing loss to dementia in older adults and synthesize the available literature demonstrating beneficial effects of hearing remediation on brain structure and function. EXPERT OPINION : Further research is needed to evaluate whether treatment of hearing loss may reduce risk of cognitive decline and improve neural consequences of hearing loss. Studies may investigate the pathologic mechanisms linking these late-life disorders and identify individuals vulnerable to dementia, and future clinical trials may evaluate whether hearing treatment may reduce the risk for dementia.
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Affiliation(s)
- Katharine K Brewster
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York State Psychiatric Institute, New York
| | - Jennifer A Deal
- Department of Otolaryngology, Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Center on Aging and Health, Johns Hopkins University School of Medicine
| | - Frank R Lin
- Department of Otolaryngology, Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University School of Medicine
| | - Bret R Rutherford
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York State Psychiatric Institute, New York, USA
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29
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Saberi N, Darvishpoor Kakhki A, Ilkhani M, Khan HTA. Falls in older ambulatory care patients with cancer in Iran: Implications for clinical practice. J Eval Clin Pract 2022; 28:624-630. [PMID: 34854180 DOI: 10.1111/jep.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE/AIM Falls can have severe consequences particularly for older patients with cancer undergoing ambulatory care. The aim of the study is to identify the predictors of falls in older patients receiving cancer ambulatory care and evaluate the accuracy of the final multivariable model in detecting older patients with falls. METHOD A retrospective study was conducted on 300 older patients aged 60 years and above that were referred for ambulatory care in three oncology clinics based at hospitals in Tehran, Iran. Participants completed a questionnaire comprising demographic, history of falls, and cancer-related factors. Logistic regression was used to determine risk factors associated with falls. RESULTS A total of 35.3% of the older patients with cancer had experienced a fall in the 6 months following the start of their ambulatory care. The most important predictors of falls include the fourth stage of cancer (odds ratio [OR]: 6.47, 95% confidence interval [CI]: 3.20-13.08, p < 0.001), fear of falling (OR: 5.64, 95% CI: 2.58-12.33, p < 0.001), use of hearing (OR: 2.38, 95% CI: 1.07-5.29, p = 0.033) and visual aids (OR: 2.36, 95% CI: 1.12-5.01, p = 0.025), and the number of visits to the doctor (OR: 1.10, 95% CI: 1.01-1.21, p = 0.035). CONCLUSIONS The results indicate that a reduction in falls is possible by introducing strategies to improve care for older patients in the advanced stage of cancer, eliminating the causes of fear of falling, examining and improving vision and hearing, and identifying and addressing the underlying causes of visits to the doctor.
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Affiliation(s)
- Najmeh Saberi
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Darvishpoor Kakhki
- Department of Medical and Surgical Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahnaz Ilkhani
- Department of Medical and Surgical Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hafiz T A Khan
- Public Health Group, College of Nursing, Midwifery and Healthcare, University of West London, London, UK
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30
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Wang J, Liu N, Zhao X. Assessing the relationship between hearing impairment and falls in older adults. Geriatr Nurs 2022; 47:145-150. [PMID: 35914491 DOI: 10.1016/j.gerinurse.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 11/04/2022]
Abstract
Falls and fall-related injuries are the major sources of mortality, disability, and dysfunction among older people. The study aimed to examine the association between hearing impairment and falls in Chinese older adults, using data from the Chinese Longitudinal Healthy Longevity Survey. The outcome variable was experienced falls in the past year, and the exposure variable was hearing impairment. The odds ratio (OR) of falls was 1.51 and 1.47 for men and women with hearing impairment than those without hearing impairment after adjusting for covariates. For participants aged 60-69 years, 70-79 years, 80-89 years, and ≥ 90 years, the OR of risk of falls associated with hearing impairment was 2.80, 1.41, 1.50 and 1.44, respectively. These results suggested that there was an association between hearing impairment and falls. Older adults with hearing impairment had a higher risk of falls than those without hearing impairment in the Chinese older population.
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Affiliation(s)
- Jin Wang
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Nan Liu
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Xiaoguang Zhao
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China; Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China.
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31
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Wang Z, Chen D, Pan T, Chen C, Guan L. Hearing loss, depression and social participation of older adults: Evidence from the China health and retirement longitudinal study. Geriatr Gerontol Int 2022; 22:529-535. [PMID: 35674053 DOI: 10.1111/ggi.14413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/11/2022] [Accepted: 05/07/2022] [Indexed: 11/27/2022]
Abstract
AIM Hearing loss and depression in older adults are associated with a lower social participation rate. However, few studies have thoroughly analyzed the relationship between them. METHODS The data were obtained from the China Health and Retirement Longitudinal Study carried out in 2011, 2013 and 2015, and data from 24 306 participants ranging in age from 50 to 80 years were used in this study. Hearing loss, depression and social participation were assessed by self-reported hearing status, the 10-item Center for the Epidemiological Studies of Depression Short Form, and self-reported social participation activity types and frequency. The fixed effects logistic regression and random effects logistic regression were used to examine the relationship between hearing loss and social participation. The Sobel method was used to explore the relationship between hearing loss, depression and social participation. RESULTS Compared with older adults without hearing loss, persons with hearing loss engaged in significantly fewer types of activities (β = -0.070, 95% CI -0.109, -0.031, P < 0.001) and at a lower frequency (β = -0.176, 95% CI -0.260, -0.093, P < 0.001). Depression significantly existed in the relationship between hearing loss and social participation as a mediating variable, and the percentage of indirect effects in this relationship were 16.5% and 20.8%. CONCLUSIONS The findings of this study suggest that when facing an aging society, improving the hearing status of older adults should be considered by policymakers. More efforts should be made to help older adults cope with depression. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Zengwen Wang
- The Center for Social Security Studies, Wuhan University, Wuhan, China
| | - Deshan Chen
- The Center for Social Security Studies, Wuhan University, Wuhan, China
| | - Tianyi Pan
- The Center for Social Security Studies, Wuhan University, Wuhan, China
| | - Chen Chen
- The Center for Social Security Studies, Wuhan University, Wuhan, China
| | - Liding Guan
- The Center for Social Security Studies, Wuhan University, Wuhan, China
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Heselton T, Bennett RJ, Manchaiah V, Swanepoel DW. Online Reviews of Hearing Aid Acquisition and Use: A Qualitative Thematic Analysis. Am J Audiol 2022; 31:284-298. [PMID: 35286155 DOI: 10.1044/2021_aja-21-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Online reviews have become increasingly common for consumers to share their experiences about products and to assist potential consumers with decision making. The current study was aimed to understand the hearing aid user experience from online consumer reviews using qualitative analysis. METHOD The study used a qualitative thematic analysis to analyze open text responses from consumers leaving hearing aid reviews on the http://www.HearingTracker.com website. One thousand three hundred seventy-eight online consumer hearing aid reviews (open-text responses) were extracted and analyzed. RESULTS Three domains emerged within the data set, containing 11 themes and 136 subthemes. Domain one (Clinical Processes) contained two themes: Hearing Assessment and Hearing Aid Acquisition. Domain two (The Device) contained five themes: Function, Performance, Physical, Device Management, and Maintenance. Domain three (The Person) contained four themes: Satisfaction, Quality of Life, Personal Adjustment, and Knowledge. The themes gave an understanding that there were a contribution of factors that formed part of a consumers hearing aid user experience. CONCLUSIONS Hearing aid users described a range of positive, negative, and neutral descriptions online about their hearing aid user experience and gave advice to fellow hearing aid users helping clinicians improve their hearing aid fitting skills in practice. These findings have implications to future product development as well as service delivery model in terms of developing strategies for fostering patient-centered audiological practice.
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Affiliation(s)
- Tayla Heselton
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Virtual Hearing Lab, Collaborative initiative between Lamar University and University of Pretoria, Gauteng, South Africa
| | - Rebecca J. Bennett
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands, Australia
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Virtual Hearing Lab, Collaborative initiative between Lamar University and University of Pretoria, Gauteng, South Africa
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, India
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Virtual Hearing Lab, Collaborative initiative between Lamar University and University of Pretoria, Gauteng, South Africa
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
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Brewster KK, Zilcha-Mano S, Wallace ML, Kim AH, Brown PJ, Roose SP, Golub JS, Galatioto J, Kuhlmey M, Rutherford BR. A precision medicine tool to understand who responds best to hearing aids in late-life depression. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5721. [PMID: 35499363 PMCID: PMC9942910 DOI: 10.1002/gps.5721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/20/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Accumulating evidence suggests that hearing loss (HL) treatment may benefit depressive symptoms among older adults with Major Depressive Disorder (MDD), but the specific individual characteristics of those who stand to improve most are unknown. METHODS N = 37 patients ≥60 years with HL and MDD received either active or sham hearing aids in this 12-week double-blind randomized controlled trial. A combined moderator approach was utilized in the analysis in order to examine multiple different pretreatment individual characteristics to determine the specific qualities that predicted the best depressive symptom response to hearing aids. Pretreatment characteristics included: Hearing Handicap Inventory for the Elderly (HHIE-S), pure tone average (PTA), speech reception threshold (SRT), Short Physical Performance Battery (SPPB), cognition (Repeatable Battery for the Assessment of Neuropsychological Status). RESULTS The analysis revealed a combined moderator, predicting greater improvement with active versus sham hearing aids, that had a larger effect size than any individual moderator (combined effect size [ES] = 0.49 [95% CI: 0.36, 0.76]). Individuals with worse hearing-related disability (HHIE-S: individual ES = -0.16), speech recognition (SRT: individual ES = -0.14), physical performance (SPPB: individual ES = 0.41), and language functioning (individual ES = 0.19) but with relatively less severe audiometric thresholds (PTA: individual ES = 0.17) experienced greater depressive symptom improvement with active hearing aids. CONCLUSIONS Older adults with relatively worse HL-related, physical, and cognitive functioning may stand to benefit most from hearing aids. Given the large number of older adults experiencing HL and MDD, a non-invasive and scalable means of targeting those most likely to respond to interventions would be valuable.
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Affiliation(s)
- Katharine K. Brewster
- Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, Box 92, New York, NY 10032
| | | | | | - Ana H. Kim
- Columbia University Vagelos College of Physicians and Surgeons, Columbia University, Department of Otolaryngology—Head and Neck Surgery
| | - Patrick J. Brown
- Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute
| | - Steven P. Roose
- Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute
| | - Justin S. Golub
- Columbia University Vagelos College of Physicians and Surgeons, Columbia University, Department of Otolaryngology—Head and Neck Surgery
| | - Jessica Galatioto
- Columbia University Vagelos College of Physicians and Surgeons, Columbia University, Department of Otolaryngology—Head and Neck Surgery
| | - Megan Kuhlmey
- Columbia University Vagelos College of Physicians and Surgeons, Columbia University Department of Otolaryngology—Head and Neck Surgery
| | - Bret R. Rutherford
- Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute
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Park J, Lee O, McKee M. Association between hearing loss and suicidal ideation among middle-aged and older adults. Aging Ment Health 2022; 26:1287-1294. [PMID: 33979563 DOI: 10.1080/13607863.2021.1919991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Hearing loss (HL) is regarded as a major risk factor for late-life depression. This study aims to further examine the association between HL and suicidal ideation (SI) among middle-aged and older adults using a nationally representative sample. METHOD The study sample comprised 34,142 adults (aged 50+) drawn from the 2015 to 2018 National Survey on Drug Use and Health. SI was measured by response to the question, 'At any time in the past year, did you seriously think about trying to kill yourself?' HL was assessed by asking respondents whether they were deaf or had serious difficulty hearing. Multivariate logistic regression analyses were conducted to examine the association between HL and SI after adjusting for a comprehensive list of covariates. RESULTS Compared to those without HL, middle-aged and older adults with HL experienced significant health disparities regarding history of hospitalization, poor perceived health, higher prevalence of chronic diseases, depression, substance use, and SI. HL was positively associated with SI in the past year in both middle-aged (aOR = 1.59, 95% CI [1.14, 2.21], p < .001) and older adult groups (aOR = 1.58, 95% CI [1.07, 2.33], p < .001), controlling for depression, substance use, health status, and sociodemographic variables. CONCLUSION Given the high prevalence of hearing loss (HL) in aging populations, this study aimed to expand our knowledge of the relative strength of association between HL and SI. Findings implied that healthcare providers should consider screening for SI in those with HL.
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Affiliation(s)
- Junghyun Park
- Silver School of Social Work, New York University, New York, NY, USA
| | - Othelia Lee
- School of Social Work, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Michael McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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Bikbov MM, Kazakbaeva GM, Rakhimova EM, Rusakova IA, Fakhretdinova AA, Tuliakova AM, Panda-Jonas S, Bolshakova NI, Safiullina KR, Gizzatov AV, Ponomarev IP, Yakupova DF, Baymukhametov NE, Nikitin NA, Jonas JB. Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study. BMJ Open 2022; 12:e058464. [PMID: 35473730 PMCID: PMC9045115 DOI: 10.1136/bmjopen-2021-058464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the prevalence of vision impairment, hearing impairment and dual sensory impairment (DSI) as combination of vision and hearing impairment, in association with cognitive dysfunction in a population aged 85+ years. METHODS The cross-sectional population-based Ural Very Old Study, conducted in rural and urban Bashkortostan, Russia, between 2017 and 2020, included a detailed ocular and systemic examination with assessment of moderate to severe vision impairment (MSVI)/blindness (best-corrected visual acuity <6/18), moderate to severe hearing loss (MSHL) and cognitive function. SETTING A rural and urban area in Bashkortostan, Russia. PARTICIPANTS Out of 1882 eligible individuals aged 85+ years, 1526 (81.1%) individuals participated. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of vision, hearing and DSI and cognitive dysfunction. RESULTS The study included 731 (47.9%) individuals (mean age 88.1±2.7 years; median 87 years, range 85-98 years) with measurements of MSVI/blindness, MSHL and cognitive function. The prevalence of MSVI/blindness, MSHL, DSI and dementia were 51.8% (95% CI 48.2% to 55.5%), 33.1% (95% CI 29.7% to 36.5%), 20.5% (95% CI 17.8% to 23.5%) and 48.2% (95% CI 44.5% to 51.8%), respectively. Lower cognitive function score was associated with lower visual acuity (p<0.001) and higher hearing loss score (p=0.03), after adjusting for older age (p=0.001), rural region of habitation (p=0.003), lower educational level (p<0.001) and higher depression score (p<0.001). Higher dementia prevalence was associated with higher MSHL prevalence (OR 2.18 95% CI 1.59 to 2.98; p<0.001), higher MSVI/blindness prevalence (OR 2.09, 95% CI 1.55 to 2.81; p<0.001) and higher DSI prevalence (OR 2.80, 95% CI 1.92 to 4.07; p<0.001). CONCLUSIONS In this very old, multiethnic population from Russia, DSI (prevalence 20.5%), as compared with hearing impairment (OR 2.18) and vision impairment alone (OR 2.09), had a stronger association (OR 2.80) with dementia. The findings show the importance of hearing and vision impairment, in particular their combined occurrence, for dementia prevalence in an old population.
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Affiliation(s)
| | | | | | | | | | | | - Songhomitra Panda-Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Manheim, Germany
| | | | | | - Ainur V Gizzatov
- Ufa Eye Research Institute, Ufa, Bashkortostan, Russian Federation
| | | | - Dilya F Yakupova
- Ufa Eye Research Institute, Ufa, Bashkortostan, Russian Federation
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Manheim, Germany
- Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
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Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients: A Retrospective Chart Review. Disabil Health J 2022; 15:101327. [DOI: 10.1016/j.dhjo.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/23/2022]
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Feldman A, Patou F, Baumann M, Stockmarr A, Waldemar G, Maier AM, Vogel A. Listen Carefully protocol: an exploratory case-control study of the association between listening effort and cognitive function. BMJ Open 2022; 12:e051109. [PMID: 35264340 PMCID: PMC8915370 DOI: 10.1136/bmjopen-2021-051109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION A growing body of evidence suggests that hearing loss is a significant and potentially modifiable risk factor for cognitive impairment. Although the mechanisms underlying the associations between cognitive decline and hearing loss are unclear, listening effort has been posited as one of the mechanisms involved with cognitive decline in older age. To date, there has been a lack of research investigating this association, particularly among adults with mild cognitive impairment (MCI). METHODS AND ANALYSIS 15-25 cognitively healthy participants and 15-25 patients with MCI (age 40-85 years) will be recruited to participate in an exploratory study investigating the association between cognitive functioning and listening effort. Both behavioural and objective measures of listening effort will be investigated. The sentence-final word identification and recall (SWIR) test will be administered with single talker non-intelligible speech background noise while monitoring pupil dilation. Evaluation of cognitive function will be carried out in a clinical setting using a battery of neuropsychological tests. This study is considered exploratory and proof of concept, with information taken to help decide the validity of larger-scale trials. ETHICS AND DISSEMINATION Written approval exemption was obtained by the Scientific Ethics Committee in the central region of Denmark (De Videnskabsetiske Komiteer i Region Hovedstaden), reference 19042404, and the project is registered pre-results at clinicaltrials.gov, reference NCT04593290, Protocol ID 19042404. Study results will be disseminated in peer-reviewed journals and conferences.
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Affiliation(s)
- Alix Feldman
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - François Patou
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
- Research and Technology Group, Oticon Medical, Smørum, Denmark
| | - Monika Baumann
- Centre for Applied Audiology Research, Oticon, Smørum, Denmark
| | - Anders Stockmarr
- Statistics and Data Analysis, Department of Mathematics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja M Maier
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
- Department of Design, Manufacturing and Engineering Management, Faculty of Engineering, University of Strathclyde, Glasgow, UK
| | - Asmus Vogel
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Guan L, Liu Q, Chen D, Chen C, Wang Z. Hearing loss, depression, and medical service utilization among older adults: evidence from China. Public Health 2022; 205:122-129. [PMID: 35278783 DOI: 10.1016/j.puhe.2022.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/05/2021] [Accepted: 01/21/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To acquire a better understanding of the mechanisms underlying the association between hearing loss and medical service utilization, this study examined the relationship between hearing loss, depression, and medical service utilization. STUDY DESIGN Using the methods of probability proportional to size, a survey conducted in 28 provinces, 150 countries/districts, 450 villages/urban communities, 11,628 households, and 19,816 individuals of China in 2018. METHODS The data for this article were derived from the 2018 China Health and Retirement Longitudinal Study, which enrolled 14,455 people aged 50-80 years. Hearing loss was determined using self-reported hearing status. Self-reported outpatient visits in the last month and hospitalization within the last year were used to determine medical service utilization. Depression was obtained from the CES-D-10 scale. Logistic regression and stepwise regression methods were used. RESULTS Older adults with hearing loss problems used significantly more outpatient care services (odds ratio [OR] = 1.292, 95% confidence interval [CI] 1.152, 1.449; P < 0.001) and inpatient care services (OR = 1.238, 95% CI 1.021, 1.501; P < 0.05) than those without hearing loss problems. Following that, individuals with hearing loss problems were more likely to experience depressive symptoms (OR = 1.467, 95% CI 1.345, 1.599; P < 0.001) than those without. Moreover, respondents with depressive symptoms used outpatient care services at a significantly higher rate (OR = 1.292, 95% CI 1.152, 1.449; P < 0.001) and inpatient care service at a significantly higher rate (OR = 1.238, 95% CI 1.021, 1.501; P < 0.05) compared with those without depressive symptom. CONCLUSION This article discovered that depression acted as a mediation variable in the relationship between hearing loss and medical service utilization. This research provided possible interventions for reducing the burden of the healthcare system and society that older adults with hearing loss imposed.
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Affiliation(s)
- Liding Guan
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Qing Liu
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Deshan Chen
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Chen Chen
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Zengwen Wang
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
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Vyas D, Brummet R, Anwar Y, Jensen J, Jorgensen E, Wu YH, Chipara O. Personalizing over-the-counter hearing aids using pairwise comparisons. SMART HEALTH (AMSTERDAM, NETHERLANDS) 2022; 23:100231. [PMID: 37397910 PMCID: PMC10312409 DOI: 10.1016/j.smhl.2021.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Over-the-counter hearing aids enable more affordable and accessible hearing health care by shifting the burden of configuring the device from trained audiologists to end-users. A critical challenge is to provide users with an easy-to-use method for personalizing the many parameters which control sound amplification based on their preferences. This paper presents a novel approach to fitting hearing aids that provides a higher degree of personalization than existing methods by using user feedback more efficiently. Our approach divides the fitting problem into two parts. First, we discretize an initial 24-dimensional space of possible configurations into a small number of presets. Presets are constructed to ensure that they can meet the hearing needs of a large fraction of Americans with mild-to-moderate hearing loss. Then, an online agent learns the best preset by asking a sequence of pairwise comparisons. This learning problem is an instance of the multi-armed bandit problem. We performed a 35-user study to understand the factors that affect user preferences and evaluate the efficacy of multi-armed bandit algorithms. Most notably, we identified a new relationship between a user's preference and presets: a user's preference can be represented as one or more preference points in the initial configuration space with stronger preferences expressed for nearby presets (as measured by the Euclidean distance). Based on this observation, we have developed a Two-Phase Personalizing algorithm that significantly reduces the number of comparisons required to identify a user's preferred preset. Simulation results indicate that the proposed algorithm can find the best configuration with a median of 25 comparisons, reducing by half the comparisons required by the best baseline. These results indicate that it is feasible to configure over-the-counter hearing aids using a small number of pairwise comparisons without the help of professionals.
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Affiliation(s)
- Dhruv Vyas
- Department of Computer Science, University of Iowa, United States of America
| | - Ryan Brummet
- Department of Computer Science, University of Iowa, United States of America
| | - Yumna Anwar
- Department of Computer Science, University of Iowa, United States of America
| | - Justin Jensen
- Department of Communication Sciences and Disorders, University of Iowa, United States of America
| | - Erik Jorgensen
- Department of Communication Sciences and Disorders, University of Iowa, United States of America
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, University of Iowa, United States of America
| | - Octav Chipara
- Department of Computer Science, University of Iowa, United States of America
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Akobirshoev I, McKee MM, Reif S, Adams RS, Li FS, Mitra M. Opioid Use Disorder-Related Emergency Department Visits Among Deaf or Hard of Hearing Adults in the United States. Disabil Health J 2022; 15:101291. [DOI: 10.1016/j.dhjo.2022.101291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 11/03/2022]
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Chern A, Sharma RK, Golub JS. Hearing Loss and Incident Dementia: Claims Data From the New York SPARCS Database. Otol Neurotol 2022; 43:36-41. [PMID: 34538853 DOI: 10.1097/mao.0000000000003338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Age-related hearing loss (HL) may be a risk factor for incident dementia. The objective was to use population-based claims data from the New York Statewide Planning and Research Cooperative System (SPARCS) to establish if HL is associated with incident dementia. STUDY DESIGN Retrospective cohort study. SETTING Comprehensive all-payer data reporting system (2007-2017). PATIENTS Two hundred six thousand eight hundred one subjects more than 60 years (56,523 with HL, random sample of 150,278 without HL). INTERVENTIONS None. MAIN OUTCOME MEASURES The main outcome was incident dementia, measured by initial dementia diagnosis (ICD-9/ICD-10 code) associated with a patient visit/insurance claim. The main exposure was HL, measured by at least two separate HL diagnoses associated with claims before dementia diagnosis. Cox proportional-hazards models were used to examine the relationship of baseline HL with incident dementia, adjusting for age, sex, cardiovascular disease, cerebrovascular disease, diabetes, and smoking. RESULTS Dementia incidence rates per 1,000 person-years were 10.16 (95% confidence interval [CI] = 9.81-10.51; subjects with HL) and 5.43 (5.28-5.57; subjects without HL). Fewer (2-10) HL claims (n = 56,523), compared with no (0) HL claims, was associated with 1.10 (95% CI = 1.05-1.15, p < 0.001) times the hazard of incident dementia, adjusting for covariates. Greater (>10) HL claims (n = 3,414), compared with no (0) HL claims, was associated with 1.63 (95% CI = 1.42, 1.86, p < 0.001) times the hazard of incident dementia, adjusting for covariates. CONCLUSIONS HL diagnosis was associated with increased risk of incident dementia based on a comprehensive all-payer data reporting system. Individuals with a more established diagnosis of HL (more HL claims) demonstrated an increased hazard ratio.
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Affiliation(s)
- Alexander Chern
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons and Columbia University Irving Medical Center/NewYork-Presbyterian Hospital
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College and NewYork-Presbyterian Hospital, New York, New York
| | - Rahul K Sharma
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons and Columbia University Irving Medical Center/NewYork-Presbyterian Hospital
| | - Justin S Golub
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons and Columbia University Irving Medical Center/NewYork-Presbyterian Hospital
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Willink A, Assi L, Nieman C, McMahon C, Lin FR, Reed NS. Alternative Pathways for Hearing Care May Address Disparities in Access. Front Digit Health 2021; 3:740323. [PMID: 34901925 PMCID: PMC8655113 DOI: 10.3389/fdgth.2021.740323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Objectives: Low-uptake of hearing aids among older adults has long dogged the hearing care system in the U.S. and other countries. The introduction of over-the-counter hearing aids is set to disrupt the predominantly high-cost, specialty clinic-based delivery model of hearing care with the hope of increasing accessibility and affordability of hearing care. However, the current model of hearing care delivery may not be reaching everyone with hearing loss who have yet to use hearing aids. In this study, we examine the group of people who do not use hearing aids and describe their characteristics and health care utilization patterns. We also consider what other healthcare pathways may be utilized to increase access to hearing treatment. Design: Cross-sectional, the 2017 Medicare Current Beneficiary Survey. Setting: Non-institutionalized adults enrolled in Medicare, the U.S. public health insurance program for older adults (65 years and older) and those with qualifying medical conditions and disabilities. Participants: A nationally representative sample of 7,361 Medicare beneficiaries with self-reported trouble hearing and/or hearing aid use. Measurements: Survey-weighted proportions described the population characteristics and health care utilization of those with hearing loss by hearing aid use, and the characteristics of those with untreated hearing loss by health care service type utilized. Results: Women, racial/ethnic minorities, and low-income Medicare beneficiaries with self-reported hearing trouble were less likely to report using hearing aids than their peers. Among those who do not use hearing aids, the most commonly used health care services were obtaining prescription drugs (64%) and seeing a medical provider (50%). Only 20% did not access either service in the past year. These individuals were more likely to be young and to have higher educational attainment and income. Conclusion: Alternative models of care delivered through pharmacies and general medical practices may facilitate access to currently underserved populations as they are particularly high touch-points for Medicare beneficiaries with untreated hearing trouble. As care needs will vary across a spectrum of hearing loss, alternative models of hearing care should look to complement not substitute for existing access pathways to hearing care.
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Affiliation(s)
- Amber Willink
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia.,Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Lama Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Carrie Nieman
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Catherine McMahon
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Hura N, Bernstein IA, Mady LJ, Agrawal Y, Lane AP, Rowan NR. Otolaryngic sensory loss as a measure of frailty among older US adults. Int Forum Allergy Rhinol 2021; 12:771-779. [PMID: 34878232 DOI: 10.1002/alr.22918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Frailty is a syndrome characterized by reduced physiologic reserve and increased vulnerability to poor health outcomes. Disruption of sensorineural function appears to serve as a novel biomarker of frailty. Using population-level data, we sought to characterize the association between otolaryngic sensory dysfunction and frailty. METHODS A cross-sectional analysis of the 2011-2012 US National Health and Nutrition Examination Survey was performed on adults ≥40 years of age (n = 2138). Participants were grouped by subjective gustatory dysfunction (sGD), olfactory dysfunction (sOD), hearing loss (sHL), and measured hearing loss (mHL) with pure tone averages (PTAs). Frailty was operationalized using a continuous 36-item frailty index (FI) scored from 0 to 1, stratified in 4 categories ("non-frail," "vulnerable," "frail," or "most frail"). RESULTS All sensory loss groups had significantly higher FI scores than those without sensory loss (sGD = 0.15; sOD = 0.14; sHL = 0.15; low-frequency mHL = 0.16; high-frequency mHL = 0.14 vs control = 0.11; p < 0.007 for all). "Vulnerable" individuals had increased odds of sOD (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.05-2.00), whereas "frail" individuals had increased odds of sOD (aOR, 1.85; 95% CI, 1.26-2.71) and low-frequency mHL (aOR, 4.01; 95% CI, 1.27-12.63). The "most frail" individuals had increased odds of sHL (aOR, 11.72; 95% CI, 2.88-47.66) and high-frequency mHL (aOR 5.10; 95% CI, 1.72-15.12). PTAs were linearly associated with FI (low: β = 10.15; 95% CI, 1.78-18.51; high: β = 19.85; 95% CI, 5.19-34.53). CONCLUSION Otolaryngic sensory loss is associated with increased frailty. Independent association of frailty with measures of olfaction and hearing suggests that olfactory and hearing assessments may help identify at-risk individuals with modifiable risk factors.
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Affiliation(s)
- Nanki Hura
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Isaac A Bernstein
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA
| | - Leila J Mady
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andrew P Lane
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
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Didczuneit-Sandhop B, Jóźwiak K, Jolie M, Holdys J, Hauptmann M. Hearing loss among elderly people and access to hearing aids: a cross-sectional study from a rural area in Germany. Eur Arch Otorhinolaryngol 2021; 278:5093-5098. [PMID: 33870450 PMCID: PMC8553687 DOI: 10.1007/s00405-021-06799-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/01/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Hearing loss is common and associated with reduced quality of life, particularly among elderly people. However, many patients do not use hearing aids. We evaluated the use of hearing aids among people with hearing loss by health services availability near their residence in a rural area in the state of Brandenburg, Germany. METHODS Audiometry was performed in a convenience sample of subjects in ten towns and hearing loss was determined, defined as a threshold of ≥ 30 dB in at least one ear and at least one of the frequencies 0.5, 1.0, 2.0 and 4.0 kHz. For each participant, age and gender were collected and whether or not hearing aids were available. RESULTS Among 186 persons with an average age of 74 years (interquartile range 71-81), 97% had hearing loss [95% confidence interval (CI) 95-100]. Among 121 patients with hearing loss who reported whether or not they have a hearing aid, 93 had no hearing aid (77%, 95% CI 69-84). The proportion of hearing-impaired persons who do not have a hearing aid significantly increased with the absence of a hearing aid specialist or ear nose throat (ENT) physician or both in the town where the tests were performed (p trend = 0.001). CONCLUSION Hearing loss is common among elderly people in the study area and many people in rural areas in Germany may not be properly supplied with hearing aids due to lack of hearing aid specialists and/or ENT physicians close to their residence. Interventions to improve this situation are urgently required.
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Affiliation(s)
- Birgit Didczuneit-Sandhop
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany.
| | - Katarzyna Jóźwiak
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Manja Jolie
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany
| | - Josefine Holdys
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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Frank A, Goldlist S, Mark Fraser AE, Bromwich M. Validation of SHOEBOX QuickTest Hearing Loss Screening Tool in Individuals With Cognitive Impairment. Front Digit Health 2021; 3:724997. [PMID: 34713195 PMCID: PMC8521917 DOI: 10.3389/fdgth.2021.724997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The aim of this study was to validate a novel iPad-based rapid hearing loss screening tool (SHOEBOX QuickTest) in individuals with cognitive impairment. Design: Cross-sectional validation study. Setting: Bruyère Research Institute, Ottawa, Canada. Subjects and Methods: Twenty-five individuals with mild cognitive impairment (MCI) and mild dementia from the Bruyère Memory Program were included in this study. The study consisted of two components: (1) SHOEBOX QuickTest hearing screener and (2) a conventional hearing test (pure tone audiometry). Measurements: Hearing was assessed at 1,000, 2,000, and 4,000 Hz separately for each ear. The agreement between hearing ability groupings (good vs. reduced) from conventional hearing test and SHOEBOX QuickTest was determined. Specifically, accuracy, sensitivity, specificity, as well as alignment between conventional thresholds and hearing threshold ranges. Results: An overall accuracy of 84% was observed for SHOEBOX QuickTest, and a sensitivity and specificity of 100 and 66.7%, respectively. 72% ([95% CI], 60.0–84.1%) of conventional audiometry thresholds were within the pre-established 10 dB SHOEBOX QuickTest. Conclusion: SHOEBOX QuickTest is a valid hearing loss screening tool for individuals with cognitive impairment. Implementing this iPad-based screening tool in memory clinics could not only aid in the timely diagnosis of hearing loss, but also assist physicians in providing a better assessment of cognitive impairment by ruling out hearing loss as a confounding variable.
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Affiliation(s)
| | | | | | - Matthew Bromwich
- SHOEBOX Ltd, Ottawa, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, CHEO, Ottawa, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada
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Marmamula S, Kumbham TR, Modepalli SB, Barrenkala NR, Yellapragada R, Shidhaye R. Depression, combined visual and hearing impairment (dual sensory impairment): a hidden multi-morbidity among the elderly in Residential Care in India. Sci Rep 2021; 11:16189. [PMID: 34376737 PMCID: PMC8355224 DOI: 10.1038/s41598-021-95576-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/20/2021] [Indexed: 12/20/2022] Open
Abstract
To report the prevalence of depression and its association with combined visual (VI) and hearing impairment (HI) in the elderly in residential care in India. Participants aged ≥ 60 years were recruited from 41 homes. Data on personal and sociodemographic information were obtained. Visual acuity was measured using the logMAR chart. Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Hearing Handicap Inventory for the Elderly Screening (HHIE) was administered to assess hearing status. Data of all 867 eligible elderly participants were analysed. The mean age of the participants was 74.2 years (standard deviation: 8.2 years) and included 537 (61.9%) women and 117 (13.5%) participants who had no education. The prevalence of depression was 60.0% (95% CI: 45.2-73.4) in the elderly with combined VI and HI compared to 20.9% (95% CI:14.4-28.8) among those with VI only and 37.8% (95% CI: 26.6-46.5) among those with HI only. On multiple logistic regression analyses, depression was approximately 5 times higher among the participants with DSI after adjusting for other covariates. Six out of ten elderly with combined HI and VI had depression highlighting the need for screening and referral when elderly present with combined vision and hearing loss.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, 500034, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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Impact of Hearing Aid Use on Falls and Falls-Related Injury: Results From the Health and Retirement Study. Ear Hear 2021; 43:487-494. [PMID: 34334680 DOI: 10.1097/aud.0000000000001111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Falls are considered a significant public health issue and falls risk increases with age. There are many age-related physiologic changes that occur that increase postural instability and the risk for falls (i.e., age-related sensory declines in vision, vestibular, somatosensation, age-related orthopedic changes, and polypharmacy). Hearing loss has been shown to be an independent risk factor for falls. The primary objective of this study was to determine if hearing aid use modified (reduced) the association between self-reported hearing status and falls or falls-related injury. We hypothesized that hearing aid use would reduce the impact of hearing loss on the odds of falling and falls-related injury. If hearing aid users have reduced odds of falling compared with nonhearing aid users, then that would have an important implications for falls prevention healthcare. DESIGN Data were drawn from the 2004-2016 surveys of the Health and Retirement Study (HRS). A generalized estimating equation approach was used to fit logistic regression models to determine whether or not hearing aid use modifies the odds of falling and falls injury associated with self-reported hearing status. RESULTS A total of 17,923 individuals were grouped based on a self-reported history of falls. Self-reported hearing status was significantly associated with odds of falling and with falls-related injury when controlling for demographic factors and important health characteristics. Hearing aid use was included as an interaction in the fully-adjusted models and the results showed that there was no difference in the association between hearing aid users and nonusers for either falls or falls-related injury. CONCLUSIONS The results of the present study show that when examining self-reported hearing status in a longitudinal sample, hearing aid use does not impact the association between self-reported hearing status and the odds of falls or falls-related injury.
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Kim Y, Yang CJ, Yoo MH, Song CI, Chung JW. Changes of Temporal Processing and Hearing in Noise after Use of a Monoaural Hearing Aid in Patients with Sensorineural Hearing Loss: A Preliminary Study. J Audiol Otol 2021; 25:146-151. [PMID: 34289535 PMCID: PMC8311061 DOI: 10.7874/jao.2021.00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives The relationship between hearing aid (HA) use and improvement in cognitive function is not fully known. This study aimed to determine whether HAs could recover temporal resolution or hearing in noise functions. Materials and Methods We designed a prospective study with two groups: HA users and controls. Patients older than 45 years, with a pure tone average threshold of worse than 40 dB and a speech discrimination score better than 60% in both ears were eligible. Central auditory processing tests and hearing in noise tests (HINTs) were evaluated at the beginning of the study and 1, 3, 6, and 12 months after the use of a monaural HA in the HA group compared to the control group. The changes in the evaluation parameters were statistically analyzed using the linear mixed model. Results A total of 26 participants (13 in the HA and 13 in the control group) were included in this study. The frequency (p<0.01) and duration test (p=0.02) scores showed significant improvements in the HA group after 1 year, while the HINT scores showed no significant change. Conclusions After using an HA for one year, patients performed better on temporal resolution tests. No improvement was documented with regard to hearing in noise.
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Affiliation(s)
- Yehree Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan Joo Yang
- Department of Otolaryngology, Hanil General Hospital, Seoul, Korea
| | - Myung Hoon Yoo
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Kyungpook National University, Daegu, Korea
| | - Chan Il Song
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Woo Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Association of self-reported hearing loss severity and healthcare utilization outcomes among Medicare beneficiaries. Am J Otolaryngol 2021; 42:102943. [PMID: 33550025 DOI: 10.1016/j.amjoto.2021.102943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/25/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Understanding health utilization trends in the elderly population is pivotal for Medicare and policymakers. This study evaluates the association between hearing status and health utilization outcomes in a representative sample of elderly Medicare beneficiaries. MATERIALS AND METHODS We employed the 2017 Medicare Current Beneficiary Survey (MCBS), which includes self-reported hearing loss data and weighted health utilization information. Analyses were limited to Medicare beneficiaries aged 65 and older without hearing aids. Multivariable logistic regression was performed to assess association between self-reported hearing loss and health utilization outcomes. RESULTS Of 7160 respondents, 55.1%, 39.9% and 4.9% reported no trouble hearing, little trouble hearing, and a lot of trouble hearing, respectively. On multivariable logistic regression, both a little and a lot of trouble hearing were associated with trouble accessing care (little trouble hearing: odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.33-2.40, p < 0.001; lot of trouble hearing: OR = 2.89, 95% CI: 1.81-4.60, p < 0.001) and emergency room (ER) visits (little trouble hearing: OR = 1.24, 95% CI: 1.08-1.42, p = 0.002; lot of trouble hearing: OR = 1.44, 95% CI: 1.10-1.89, p = 0.01). A lot of trouble hearing was associated with avoiding doctor visits (OR = 1.63 95% CI: 1.21-2.21, p = 0.002). Self-reported hearing status was not associated with inpatient or skilled nursing facility (SNF) admission on adjusted analyses. CONCLUSIONS Increasing reported hearing loss severity is associated with decreased access to and avoidance of routine medical visits, and increased utilization of ER visits. These findings have important implications for Medicare, clinicians and policymakers. Further studies should evaluate if hearing aids can mitigate these outcomes.
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Assi L, Reed NS, Nieman CL, Willink A. Factors Associated With Hearing Aid Use Among Medicare Beneficiaries. Innov Aging 2021; 5:igab021. [PMID: 34316520 PMCID: PMC8306709 DOI: 10.1093/geroni/igab021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 12/05/2022] Open
Abstract
Background and Objectives In the United States, up to two-thirds of older adults have hearing loss. Untreated hearing loss can have significant health outcomes, yet less than 20% of adults with hearing loss use hearing aids. In this study, we examined potential factors associated with hearing aid use, including detailed measures of health status, access to care, patient engagement, and technology use, in a nationally representative sample of Medicare beneficiaries. Research Design and Methods Cross-sectional study using the 2017 Medicare Current Beneficiary Survey. Participants with self-reported hearing loss were included. The primary outcome was hearing aid use. Factors potentially associated with hearing aid use included: sociodemographics, health determinants, access to care, patient activation, and technology access/use. Results Overall, 5,146 participants were included. Of them, 27% reported using hearing aids. In a multivariable logistic regression model, predisposing factors associated with greater odds of hearing aid use included older age, identifying as a man, identifying as White, having completed college, having 3 or more chronic conditions, having dementia, not having trouble seeing, not having limitations in activities of daily living, having moderate relative to low information-seeking scores, and having a personal computer at home (range of odds ratios [ORs]: 1.22–4.46). Enabling factors associated with greater odds of hearing aid use included higher income, living alone relative to living with family members other than a spouse, and having a usual source of care (range of ORs: 1.43–1.54). Discussion and Implications In addition to addressing previously identified factors associated with hearing aid use, improving access to health care, technology, and information about hearing aids may improve the uptake of hearing aids. These findings help further inform our understanding on how to address low treatment levels of hearing loss in the community by identifying new populations to target and potentially modifiable risk factors for hearing aid use.
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Affiliation(s)
- Lama Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carrie L Nieman
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Amber Willink
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, Australia
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